TURBT术后灌注不同剂量丝裂霉素对肿瘤复发的影响

目的:探讨经尿道膀胱肿瘤电切术(Transurethral resection of bladder tumor,TURBT)术后灌注不同剂量丝裂霉素对非肌层浸润性膀胱肿瘤(Non-muscularized invasive bladder tumor,NIMBC)复发率的影响。方法:选择三原县医院2013年1月至2016年12月收治的90例NIMBC患者,根据入院先后顺序分为A、B、C三组,A组TURBT后即刻给予20 mg丝裂霉素,B组给予30 mg丝裂霉素,C组给予40 mg丝裂霉素,对比三组患者术后不同时间点的复发率、平均复发时间、膀胱刺激综合征及其他不良反应。结果:三组术后不同时间点NIMBC复发率为A组B组C组。术后12个月、18个月、24个月时A组的复发率明显高于C组(P0.05),其余时间点组间对比无统计学意义(P0.05)。三组膀胱刺激综合征发生率C组B组A组,但组间对比无统计学意义(P0.05)。三组患者均完成丝裂霉素灌注治疗,未出现因严重膀胱刺激征无法耐受而中断膀胱治疗者。本研究所有患者灌注后未发现骨髓抑制、肝肾功能异常者。结论:TURBT术后即刻应用40 mg丝裂霉素,可显著降低患者的NIMBC复发率,通过术前、术后服用琥珀酸索利那新,可降低患者的膀胱刺激综合征,辅助患者完成TURBT术后丝裂霉素灌注化疗。

The Influence of Different Doses of Mitomycin Perfusion on Tumor Recurrence After TURBT Surgery

ABSTRACT Objective: To investigate the effect of different doses of mitomycin perfusion after transurethral resection of bladder tumor (TURBT) on the recurrence rate of non-muscularized invasive bladder tumor (NIMBC). Methods: 90 cases with NIMBC from Jan. 2013 to Dec. 2016 in Sanyuan County hospital were chosen and who were divided into the A, B, C groups, the group A TURBT was immediately given 20 mg mitomycin, the group B was given 30 mg mitomycin, group C were given 40 mg mitomycin, the recurrence rate, mean recurrence time, bladder stimulation syndrome and other adverse reactions were compared among the three groups. Results: The recurrence rate of NIMBC at different postoperative time points in the three groups was group A > group B >group C. The recurrence rate of group A was significantly higher than that of group C at 12, 18 and 24 months after operation(P<0.05), and there was no statistically significant difference between the groups at other time points(P>0.05). The bladder stimulation syndrome incidence in three groups was group C> group B> group A, while which had no significant difference(P>0.05). All patients in the three groups were completed the mitomycin perfusion therapy, and no patients were found to interrupt the bladder therapy due to severe bladder irritation intolerance. There were no bone marrow suppression or abnormal liver and kidney functions were found in all patients after perfusion. Conclusion: The TURBT immediately after the application of 40 mg mitomycin, which could significantly reduce the recurrence rate of NIMBC patients, by preoperative and postoperative use of succinol solinaxine, and reduce the bladder stimulation syndrome of patients, assist patients to complete the infusion chemotherapy of TURBT after mitomycin.